Salivary cortisol output before and after cognitive behavioural therapy for chronic fatigue syndrome.
BACKGROUND
There is evidence that patients with chronic fatigue syndrome (CFS) have mild hypocortisolism. One theory about the aetiology of this hypocortisolism is that it occurs late in the course of CFS via factors such as inactivity, sleep disturbance, chronic stress and deconditioning. We aimed to determine whether therapy aimed at reversing these factors--cognitive behavioural therapy for CFS--could increase cortisol output in CFS.


METHODS
We measured diurnal salivary cortisol output between 0800 and 2000 h before and after 15 sessions (or 6 months) of CBT in 41 patients with CDC-defined CFS attending a specialist, tertiary outpatient clinic.


RESULTS
There was a significant clinical response to CBT, and a significant rise in salivary cortisol output after CBT.


CONCLUSIONS
We were unable to control for the passage of time using a non-treated CFS group.


CONCLUSIONS
Hypocortisolism in CFS is potentially reversible by CBT. Given previous suggestions that lowered cortisol may be a maintaining factor in CFS, CBT offers a potential way to address this.
Roberts
Amanda D L
AD
King's College London, Institute of Psychiatry, Department of Psychological Medicine, De Crespigny Park, London SE5 8AF, UK.
Papadopoulos
Andrew S
AS
Wessely
Simon
S
Chalder
Trudie
T
Cleare
Anthony J
AJ
D000328:Adult; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000097:blood / Q000523:psychology / Q000628:therapy; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012463:Saliva / Q000737:chemistry; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D006854:Hydrocortisone